33-Year-Old With Pleuritic Chest Pain

33-Year-Old With Pleuritic Chest Pain

A 33-year-old female presents to urgent care with pleuritic chest pain that is gradual in onset over the preceding several days and worse when lying flat. She denies fever, cough, and shortness of breath. She is well appearing with normal vital signs. An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

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63-Year-Old With Sudden Visual Disturbance

63-Year-Old With Sudden Visual Disturbance

A 63-year-old man presents to urgent care with sudden-onset floaters and blurred vision in his right eye for one day. He denies trauma, headache, or flashes of light. He has no history of similar symptoms. His past medical history includes hypertension and type 2 diabetes. Vital signs are normal. Visual acuity measures 20/40 OD and 20/25 OS. No facial asymmetry or eyelid swelling is noted. Visual fields are intact bilaterally. A non-dilated fundoscopic exam is …

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55-Year-Old With Diffusely Dry Skin

55-Year-Old With Diffusely Dry Skin

A 55-year-old woman presents to urgent care because of skin dryness and scaling on her legs that developed 2 weeks prior. The patient was recently diagnosed with psoriasis by a different provider and was treated with a combination therapy of tazarotene and a topical steroid for over 4 weeks. Diffuse dryness and white scales were seen on her legs. View the image below and consider what your diagnosis and next steps would be. Resolution of …

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55-Year-Old With Hand Rash

55-Year-Old With Hand Rash

A 55-year-old woman presents to urgent care with complaints of arthralgia and a pustular rash on her hands. She has a past medical history of Crohn disease and has taken infliximab as treatment for the past year. The patient has no recent history of travel or infections and no history of any skin conditions. On dermatological examination, multiple pustules, some becoming confluent to form “lakes of pus,” were seen on the palms and fingers. Bacterial …

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28-Year-Old With Foot Pain

28-Year-Old With Foot Pain

A 28-year-old woman presents to urgent care after an indoor rock-climbing event. She fell 10 feet from the wall without any safety gear to break the fall. She describes deep pain in her left foot, and she is limping. An exam reveals dorsal and plantar midfoot tenderness and bruising across the dorsal foot. A 3-view x-ray series is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the …

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65-Year-Old With Hypertension

65-Year-Old With Hypertension

A 65-year-old female with a history of hypertension presents with chest pain and dyspnea for 1 day. She denies fever, cough, nausea, vomiting, or abdominal pain. Upon arrival to urgent care, her respiratory rate was 28 breaths per minute, blood pressure 179/102, and oxygen saturation 92% on room air. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on …

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36-Year-Old With Hair Loss

36-Year-Old With Hair Loss

A 36-year-old man presents to urgent care with asymptomatic hair loss that developed on multiple sites of his scalp over the previous 2 months. The hair loss developed in round patches that expanded to involve most of the back of his scalp. His past medical history is notable for hyperthyroidism. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

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